The migraine is considered the more common neurological disease in our midst. According to data from the Spanish Society of Neurology, this pathology affects 12-13% of the Spanish population, with a predominance in the female sex and in middle-aged patients.
Unlike other diseases, patients usually come to their workplace presenting migraine, implying a decrease of more than 50% in their labor productivity, which is known by the term “labor presenteeism”. To this are added the direct costs of the disease, which include economic spending on treatments, diagnosis, assistance to medical centers and hospitalizations. A study published in 2017 by a Spanish group calculated that the total cost of migraine per patient and year amounted to € 5,041.38, reaching the € 12,970.08 in patients with chronic migraine.
All this together with el impact on the patient’s quality of life and their relatives, make migraine continue to be one of the main causes of disability in working-age patients.
What is migraine
It is a type of headache influenced by genetic and environmental factors; up to 45% of the direct descendants of a person with migraine will be affected by it. Is it so various brain structures involved such as the hypothalamus, the cerebral cortex, the brain stem, the trigeminal system and the meningeal vessels, among others.
It is usually a unilateral headache, pulsatile, of moderate-severe intensity and that worsens with movements. Many patients have discomfort with light, Sound and certain smells. In addition, you can be accompanied by nausea, vomiting Y gastrointestinal upset.
Up to a third of patients have transient neurological symptoms that usually appear prior to the onset of pain such as visual disturbances (photopsies, zigzag lines, vision “through water”), difficulty in expressing language, sensory or motor disturbances.
Not only pain can be disabling; many patients present symptoms up to 3 days before the migraine consisting of drowsiness and yawning, difficulty in concentration, increased appetite or craving for certain foods, irritability or sadness. And also days after, often referred to as “Hangover migraine”, consisting of dizziness, tiredness and again decreased ability to concentrate.
The importance of an early approach
Migraine it can become chronic, defining this as the presence of more than 15 monthly migraine episodes for more than 3 months in a row, which implies a worse response to treatments and a significant worsening in quality of life.
They have been identified risk factors for migraine chronification As the overweight and the obesity, the self-medication, the delay in diagnosis and initiation of treatment, some drugs such as oral contraceptives, sleep apnea, the hypothyroidism and the comorbidity with other common pathologies in patients with migraine (depression, anxiety, sleep disorders, chronic pain, fibromyalgia, etc).
It is especially important to identify patients with these risk factors to start a more aggressive and earlier treatment and avoid chronification.
How to treat migraine
Currently there is a wide range of therapeutic possibilities. Two are distinguished types of treatments: the treatments focused on cutting the migraine attack or symptomatic treatment, and preventive treatments that aim to reduce the number of migraine days, their duration and intensity. The first group includes non-steroidal anti-inflammatory drugs, triptans, corticosteroids, and anesthetic pericranial nerve blocks. As for preventive treatments, oral drugs, botulinum toxin infiltrations (BOTOX ®) and injectable monoclonal antibodies directed against the CGRP receptor (a molecule involved in the pathophysiology of migraine) are available.
The choice of drug type it will depend on the individual patient characteristics Y associated diseases, the number of migraine days per month, the impact on quality of life Y disability (can be evaluated through different scales), characteristics of migraine, patient preferences and response to previous treatments.
Son essential, also a good night rest, a healthy diet, a orderly lifestyle and the realization of regular physical exercise.
Consult your doctor for more information.
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Eddie is an Australian news reporter with over 9 years in the industry and has published on Forbes and tech crunch.